Given the current trend towards more lasting eating patterns, plant-based diets will there’s no doubt whatsoever be particularly promoted and promoted. Therefore, it is important that evidence of its relationship with health is analyzed and accumulated; and if it comes from the Cochrane initiative, even better, since its name is usually a guarantee of a high level of rigor and reliability in systematic reviews.
The diet that most rigorously follows an exclusively plant-based plan is the vegan one, as part of a ideology that is increasingly gaining ground. It should be noted that Cochrane has already carried out a review on vegan diets a couple of years agoanalyzing the effect of this type of diet on cardiovascular health. But they updated it just today, publishing the work”Vegan dietary model for the primary and secondary prevention of cardiovascular diseases” (2021), so it’s time to catch up
Without further ado, this would be the translation of the main conclusions of the review, in the “friendly” language that Cochrane has accustomed us to:
“(…) We found 13 randomized controlled trials (RCTs) (in 38 articles) that met our criteria. We grouped the studies into the following three categories for interpretation of the results:
1.Vegan dietary intervention versus no intervention or minimal intervention to prevent the development of cardiovascular disease;
2. Vegan dietary intervention compared to other dietary interventions to prevent the onset of cardiovascular diseases;
3. Vegan dietary intervention compared to another dietary intervention in people with existing cardiovascular disease, to prevent recurrence.
None of the studies reported the occurrence of cardiovascular disease in people with or without the disease. Risk factors for cardiovascular disease have been reported. There was evidence with moderate certainty of some small reductions in lipid levels with the vegan diet compared to no intervention or minimal intervention in people without disease, but also some vrey small changes in the opposite direction. In people who already had cardiovascular disease, data was very limited, as onyl one study met our criteria. Four studies reported side effects of the diet, which were mild or absent.
Most studies had limitations in design, so evidence should be
Conclusions:
The review concludes that there is currently no information on the effects of a vegan diet on the onset of cardiovascular disease. There is limited information on the effects of diet in those who already have cardiovascular disease and conflicting results on risk factors for those without cardiovascular disease. we found that there are eight more studies underway, and when we have the results, we will incorporate them into the review to help reduce uncertainty.
The studies were generally small with few participants in each group. None of the included studies reported clinical cardiovascular disease events. Currently, there is insufficient information to draw conclusions about the effects of vegan dietary interventions on cardiovascular disease risk factors. (…) There is a paucity of evidence regarding secondary prevention.”
For those wishing to know the results in more detail, this is their summary, translated from the text of original abstract:
“We found thirteen randomized controlled trials-RCTs (38 articles, seven study registers) and eight ongoing studies that met the inclusion criteria. The majority of studies investigated primary prevention (four category 1 studies, eight studies category 2 and one category 3 study) None of the studies reported on clinical endpoints were included;
In category 1 there was evidence with moderate certainty from four studies with 449 participants that a vegan diet likely led to a small reduction in total cholesterol (-0.24 mmol/L) and LDL cholesterol (0.22 mmol/L) , a very small reduction in HDL cholesterol levels (-0.08 mmol/L) and a very small increase in triglyceride levels (0.11 mmol/L). The very small changes in HDL and triglyceride levels are in the opposite direction than expected. There was no evidence of an effect of the vegan dietary intervention on systolic and diastolic blood pressure (low certainty evidence).
For category 2, evidence of the effect of the vegan dietary intervention on total cholesterol levels was lacking (-0.04 mmol/L; four studies, 163 participants; low-certainty evidence). There was likely little or no effect of the vegan dietary intervention on LDL cholesterol (-0.05 mmol/L, 4 studies, 244 participants) or HDL cholesterol (-0.01 mmol/L, 5 studies) levels., 256 participants) or triglycerides (0.21 mmol/L). THE; 5 studies,256 participants) compared to other dietary interventions (moderate certainty evidence). We are uncertain about any effects of the vegan dietary intervention on systolic blood pressure (0.02 mmHg) or diastolic blood pressure (0.63 mmHg, five studies, 247 participants (very low certainty evidence).
Only one study (63 participants) contributed to category 3, where there was a lack of evidence of an effect of the vegan dietary intervention on lipid levels or blood pressure compared to other dietary interventions (low or very low certainty evidence). Four studies reported adverse events, which were nonexistent or mild.
Authors’ conclusions: Studies were generally small with few participants in each comparison group. None of the included studies reported clinical cardiovascular disease events. Currently, there is insufficient information to draw conclusions about the effects of vegan dietary interventions on cardiovascular disease risk factors. The eight ongoing studies identified will add evidence and report on primary prevention. “There is a paucity of evidence for secondary prevention.”
In short, it truly seems that to date the evidence is very scarce. The ongoing trials seem to provide a lot of additional evidence, so we will have to stay tuned for future updates.
For those who want to know the review in its entirety, which is quite extensive, you can do so at this link.
Update:
Its conclusions are similar to the previous one and its authors also found no concrete evidence of a relationship.
how can individuals ensure nutritional adequacy while following a vegan diet?
Interview: Editor of Time.news (E) and Cochrane Review Expert (C)
E: Welcome, and thank you for joining us today.The recent Cochrane review on vegan diets and thier impact on cardiovascular health has garnered significant attention. Could you start by explaining the key findings from this updated review?
C: Absolutely, and thank you for having me. The updated Cochrane review focused on the effects of vegan dietary interventions on cardiovascular disease prevention. We analyzed 13 randomized controlled trials, encompassing 38 articles, and categorized them into three main areas: vegan diets versus no intervention, vegan diets compared to other dietary options, and vegan diets in individuals with existing cardiovascular conditions.
E: That sounds comprehensive, but what did the review ultimately conclude about the impact of vegan diets on cardiovascular health?
C: Unluckily, the conclusion was a bit sobering. While we did find some moderate certainty evidence of small reductions in lipid levels in individuals without cardiovascular disease, there were also small changes that leaned in the opposite direction. More critically, none of the studies reported on actual occurrences of cardiovascular disease events. For those who already had cardiovascular disease, the data was very limited, with only one study meeting our criteria.
E: So, it seems like there’s still a lot we don’t no. What about the side effects of following a vegan diet?
C: The studies that we reviewed reported minimal side effects, mostly mild or absent. this suggests that a vegan diet might potentially be safe for many individuals, but that doesn’t equate to definitive benefits in terms of cardiovascular disease prevention.
E: With the rising popularity of plant-based diets, is there a contradiction here? many people are turning to vegan diets for health benefits, yet your review shows limited evidence supporting its effectiveness in preventing cardiovascular issues.
C: That’s a great question. Indeed, many individuals adopt vegan diets believing thay are inherently healthier, but the evidence regarding long-term health outcomes, notably cardiovascular health, is still developing.Our review highlights the urgent need for larger-scale, high-quality studies. Interestingly, we noted that there are eight ongoing studies that could provide more clarity on this subject in the future.
E: It seems more research is essential. With the trend towards plant-based diets gaining traction, how do you envision future studies addressing these gaps?
C: Future studies should prioritize larger participant groups and more robust designs to ensure that we can reliably ascertain the effects of vegan diets on cardiovascular health. It would also be beneficial to focus on specific populations that might be more susceptible to cardiovascular issues,effectively tailoring the research to capture varied impacts.
E: It sounds like the field is ripe for exploration. in light of the findings, what would be your recommendations for individuals considering adopting a vegan diet primarily for cardiovascular health?
C: My recommendation would be to approach the vegan diet as part of a broader lifestyle change that includes regular physical activity, stress management, and regular health screenings. While it may have potential benefits, individuals should consult with healthcare providers to create a personal nutrition plan and ensure that all nutritional needs—being mindful of possible deficiencies—are met.
E: Thank you for that sound advice. Any final thoughts you’d want to leave our readers with regarding vegan diets and cardiovascular health?
C: I’d stress the importance of maintaining an open mind about dietary choices. While vegan diets can certainly be part of a healthy lifestyle, it’s essential to stay informed on the latest research and to understand that balance is vital in any diet.
E: Thank you so much for your insights today. The discussion around vegan diets and health is certainly ongoing, and your expert views shed much-needed light on the current state of research.
C: Thank you for having me.It’s a pleasure to share these findings and engage in meaningful conversation about health and nutrition.
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end of Interview**